2 total
Insurer's request for reconsideration dismissed; adjudicator's minor factual errors did not affect the outcome.
The respondent insurer requested a reconsideration of a Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) and awarded six treatment plans.
The insurer argued the adjudicator violated procedural fairness and made significant errors of fact and law by relying on unsupported submissions, making medical conclusions not in the records, and misinterpreting various medical assessment reports.
The Vice-Chair found that while the adjudicator made two minor errors of fact, they were not significant enough to alter the outcome, as there was ample other evidence supporting the chronic pain diagnosis and the reasonableness of the treatment plans.
The request for reconsideration was dismissed.
Non-earner benefit denied; applicant's inability to live a normal life stemmed from a prior accident.
The applicant sought a non-earner benefit following a motor vehicle accident in October 2014.
The respondent denied the claim, arguing that any inability to live a normal life was caused by a prior accident in September 2013.
The Tribunal applied the Heath framework and found that the applicant's lifestyle changes were attributable to the 2013 accident, as supported by independent medical examinations and the applicant's own examination under oath.
The application for a non-earner benefit was dismissed.
